Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial.

OBJECTIVE: To investigate the effects of an osteopathic manipulative treatment (OMT), which includes a diaphragm intervention compared to the same OMT with a sham diaphragm intervention in chronic nonspecific low back pain (NS-CLBP). DESIGN: Parallel group randomized controlled trial. SETTING: Private and institutional health centers. PARTICIPANTS: Participants (N=66) (18-60y) with a diagnosis of NS-CLBP lasting at least 3 months. INTERVENTIONS: Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33) or the same OMT protocol with a sham diaphragm intervention (n=33), conducted in 5 sessions provided during 4 weeks. MAIN OUTCOME MEASURES: The primary outcomes were pain (evaluated with the Short-Form McGill Pain Questionnaire [SF-MPQ] and the visual analog scale [VAS]) and disability (assessed with the Roland-Morris Questionnaire [RMQ] and the Oswestry Disability Index [ODI]). Secondary outcomes were fear-avoidance beliefs, level of anxiety and depression, and pain catastrophization. All outcome measures were evaluated at baseline, at week 4, and at week 12. RESULTS: A statistically significant reduction was observed in the experimental group compared to the sham group in all variables assessed at week 4 and at week 12 (SF-MPQ [mean difference -6.2; 95% confidence interval, -8.6 to -3.8]; VAS [mean difference -2.7; 95% confidence interval, -3.6 to -1.8]; RMQ [mean difference -3.8; 95% confidence interval, -5.4 to -2.2]; ODI [mean difference -10.6; 95% confidence interval, -14.9 to 6.3]). Moreover, improvements in pain and disability were clinically relevant. CONCLUSIONS: An OMT protocol that includes diaphragm techniques produces significant and clinically relevant improvements in pain and disability in patients with NS-CLBP compared to the same OMT protocol using sham diaphragm techniques.

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches.

Women with schizophrenia have specific health needs that differ from those of men and that change through successive life stages. We aimed to review the biopsychosocial literature on schizophrenia that addresses clinically important questions related to the treatment of women, including somatic morbi-mortality, hyperprolactinemia, comorbid substance use disorders, social risk factors, and medication effectiveness/safety. Data search terms were as follows: (Morbidity AND mortality) OR hyperprolactinemia OR ("substance use disorders" OR addictions) OR ("social risk factors") OR ("drug safety" OR prescription) AND women AND schizophrenia. A secondary aim was to describe a method of monitoring and interdisciplinary staff strategies. Schizophrenia patients show an increased risk of premature death from cardiovascular/respiratory disease and cancer compared to the general population. The literature suggests that close liaisons with primary care and the introduction of physical exercise groups reduce comorbidity. Various strategies for lowering prolactin levels diminish the negative long-term effects of hyperprolactinemia. Abstinence programs reduce the risk of victimization and trauma in women. Stigma associated with women who have serious psychiatric illness is often linked to reproductive functions. The safety and effectiveness of antipsychotic drug choice and dose differ between men and women and change over a woman's life cycle. Monitoring needs to be multidisciplinary, knowledgeable, and regular.

Schizophrenia: A Review of Social Risk Factors That Affect Women.

Social risk factors are long-term or repeated environmental exposures in childhood and youth that change the brain and may, via epigenetic effects, change gene expression. They thus have the power to initiate or aggravate mental disorders. Because these effects can be mediated via hormonal or immune/inflammatory pathways that differ between men and women, their influence is often sex-specific. The goal of this narrative review is to explore the literature on social risk factors as they affect women with schizophrenia. We searched the PubMed and Scopus databases from 2000 to May 2023 using terms referring to the various social determinants of health in conjunction with "women" and with "schizophrenia". A total of 57 studies fulfilled the inclusion criteria. In the domains of childhood and adult abuse or trauma, victimization, stigma, housing, and socioeconomics, women with schizophrenia showed greater probability than their male peers of suffering negative consequences. Interventions targeting appropriate housing, income support, social and parenting support, protection from abuse, violence, and mothering-directed stigma have, to different degrees, yielded success in reducing stress levels and alleviating the many burdens of schizophrenia in women.

Psychological distress, dyadic adjustment and family dynamics after prenatal diagnosis of congenital heart disease.

INTRODUCTION: Congenital heart disease (CHD) is one of the most frequent congenital diseases. When expectant fathers and mothers are informed of a CHD during pregnancy, they have to confront a series of individual and interpersonal psychological changes. The aim of the study was to evaluate the psychological impact of a prenatal diagnosis of CHD on expectant parents. The sample included 214 participants, mothers and their partners (case group, 57 pregnant women carrying a foetus with CHD and their partners and control group, 50 pregnant women and their partners). METHOD: Administration of the BSI-18, the DAS and FACES-III following prenatal diagnosis. RESULTS: Many parents (approximately 83.6%) went through stages of shock and denial in response to the diagnosis of disease that they had to confront and accept. At the individual level, 35.1% of fathers and 47.4% mothers had clinically significant scores of psychological distress. At the couple level, both fathers (77%) and mothers (82.4%) had expressed an idealized dyadic adjustment. Lastly, the perception of the family dynamic by 43.9% of fathers and 42.2% of mothers was in the mid range. CONCLUSION: The results highlight the complexity of the initial stage that these couples were going through.

[Psychological distress, dyadic adjustment and family dynamics after prenatal diagnosis of congenital heart disease]. / Malestar psicológico, ajuste diádico y dinámica familiar tras el diagnóstico prenatal de cardiopatía congénita.

INTRODUCTION: Congenital heart disease (CHD) is one of the most frequent congenital diseases. When expectant fathers and mothers are informed of a CHD during pregnancy, they have to confront a series of individual and interpersonal psychological changes. The aim of the study was to evaluate the psychological impact of a prenatal diagnosis of CHD on expectant parents. The sample included 214 participants, mothers and their partners (case group, 57 pregnant women carrying a foetus with CHD and their partners; and control group, 50 pregnant women and their partners). METHOD: Administration of BSI-18, DAS and FACES-III following prenatal diagnosis. RESULTS: Many parents (approximately 83.6%) went through stages of shock and denial in response to the diagnosis of disease that they had to confront and accept. At the individual level, 35.1% of fathers and 47.4% mothers had clinically significant scores of psychological distress. At the couple level, both fathers (77%) and mothers (82.4%) had expressed an idealized dyadic adjustment. Lastly, the perception of the family dynamic by 43.9% of fathers and 42.2% of mothers was in the mid-range. CONCLUSION: The results highlight the complexity of the initial stage that these couples were going through.

Biobased Waterborne Polyurethane-Ureas Modified with POSS-OH for Fluorine-Free Hydrophobic Textile Coatings.

Waterborne polyurethane-urea dispersions (WPUD), which are based on fully biobased amorphous polyester polyol and isophorone diisocyanate (IPDI), have been successfully synthesized obtaining a finishing agent that provides textiles with an enhanced hydrophobicity and water column. Grafting of trans-cyclohexanediol isobutyl POSS (POSS-OH) to the biobased polymer backbone has also been investigated for the first time and its properties compared to a standard chain extender, 1,3-propanediol (PDO). The chemical structure of WPUD has been characterized by Fourier-transform infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR). The thermal properties have been evaluated by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). Mechanical properties have been studied by tensile stress-strain analysis. Moreover, the particle size, particle size distribution (PSD), and stability of developed waterborne dispersions have been assessed by dynamic light scattering (DLS), Z-potential, storage aging tests, and accelerated aging tests by analytical centrifuge (LUM). Subsequently, selected fabrics have been face-coated by the WPUD using the knife coating method and their properties have been assessed by measuring the water contact angle (WCA), oil contact angle (OCA), water column, fabric stiffness, air permeability, and water vapor resistance (breathability). Finally, the surface morphology and elemental composition of uncoated and coated fabrics have been studied by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS), respectively. All of the synthesized polyurethane-ureas provided the coated substrates with a remarkable hydrophobicity and water column, resulting in a more sustainable alternative to waterproof coatings based on fluoropolymers, such as PTFE. Grafting POSS-OH to the polymeric backbone has led to textile coatings with enhanced hydrophobicity, maintaining thermal, mechanical, and water column properties, giving rise to multifunctional coatings that are highly demanded in protective workwear and technical textiles.

Biobased Waterborne Polyurethane-Urea/SWCNT Nanocomposites for Hydrophobic and Electrically Conductive Textile Coatings.

Waterborne polyurethane-urea dispersions (WPUD), which are based on 100% bio-based semi-crystalline polyester polyol and isophorone diisocyanate, have been successfully synthesized and doped with single-walled carbon nanotubes (SWCNT) to obtain a finishing agent that provides textiles with multifunctional properties. The chemical structure of WPUD has been characterized by Fourier-transform infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR). The thermal properties have been evaluated by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and dynamic mechanical thermal analysis (DMTA). Mechanical properties have been studied by tensile stress-strain analysis. Moreover, the particle size, particle size distribution (PSD), and stability of developed waterborne dispersions have been assessed by dynamic light scattering (DLS), Z-potential, and accelerated aging tests (analytical centrifugation). Subsequently, selected fabrics have been face-coated by the WPUD using knife coating method and their properties have been assessed by measuring water contact angle (WCA), water column, fabric stiffness, and air permeability. The electrical conductivity of textiles coated with SWCNT-doped WPUD has been evaluated by EN 1149 standard. Finally, the surface morphologies of uncoated and coated fabrics have been studied by scanning electron microscopy (SEM). All of the synthesized polyurethane-ureas provide the coated substrates with remarkable water-repellency and water column, being therefore a more sustainable alternative to waterproof coatings based on fluoropolymers, such as PTFE. The additivation of the polymeric matrices with SWCNT has led to textile coatings with excellent electrical conductivity, maintaining water column properties, giving rise to multifunctional coatings that are highly demanded in protective workwear and technical textiles.

Proyecto Piloto de Unidad Funcional para Mujeres con Esquizofrenia: Modelo Asistencial de Observatorio-Monitorización-Intervención / Pilot project of a functional unit for women with Schizophrenia: observatory-monitoring-intervention Care model

En los Centros de Salud Mental de Adultos (CSMAs) del Hospital Universitari Mutua Terrassa, en enero de 2023, iniciamos un proyecto piloto de innovación asistencial denominado Unidad Funcional para Mujeres con Esquizofrenia. El objetivo principal de esta comunicación es describir el proceso de designación de las mujeres diana en la unidad, y describir las funciones de los Observatorios de salud física, salud mental y de factores de riesgo psicosocial e inclusión de estas pacientes en los observatorios de salud. De forma complementaria, se describirá el diseño de las Estaciones de Monitorización /Equipos de Vigilancia y las actuaciones o intervenciones específicas centradas en la atención de las necesidades individuales. En la primera fase del proyecto (Enero-Marzo 2023) se revisan las historias clínicas de las mujeres con esquizofrenia para revisar vinculación a profesionales y programas comunitarios. Se describen necesidades de salud física y se revisan antecedentes de consumo de sustancias, uso de benzodiazepinas y opioides, así como aspectos de seguridad farmacológica. En la segunda fase del proyecto (Abril-Junio 2023) se han desarrollado 5 grupos de trabajo (Observatorios de Salud y de Riesgo Psicosocial): 1)Morbi-mortalidad somática, 2)hiperprolactinemia, 3)consumo de sustancias, 4)exclusión social y discriminación, y 5)prescripción y seguridad farmacológica. En la tercera fase del proyecto (Jumio-Septiembre 2023) se desarrollan los Equipos de Vigilancia/Monitorización en Morbi-Mortalidad Somática, hiperprolactinemia, consumo de sustancias, exclusión social/discriminación y seguridad farmacológica, así como intervenciones específicas: colaboración con otras especialidades médicas, consultoría con atención primaria, grupos de ejercicio físico y equipos de intervención en crisis.(AU)

In the context of the Adult Community Mental Health Units (CMHUs) of the Mutua Terrassa University Hospital, we initiated a pilot project of clinical innovation called the Functional Unit for Women with Schizophrenia in January 2023. The main objective of this report is to describe the process of designing a unit targeting women, to characterize the functions of the observatories of Physical Health, Mental Health, and Psychosocial Risk Factors, and to illustrate how these observatories provide surveillance of women’s health needs. The report also describes Monitoring Stations, Vigilance teams, and specific interventions.In the first phase of the project (January - March 2023), medical records from all women with schizophrenia were reviewed to ascertain compliance with clinical appointments and community programs. During this phase, we reviewed physical health records, history of substance use disorders including the use of benzodiazepines and opioid drugs, as well as related aspects of drug safety. In the second phase of the project (April - June 2023), five Observatories of health and social risk factors were developed: 1) somatic morbi-mortality, 2) hyperprolactinemia, 3) use of substances, 4) social exclusion and discrimination, and 5) prescription and drug safety. In the third phase of the project (June-September 2023), we are developing Monitoring Stations or Vigilance teams in these five areas as well as introducing specific interventions: collaboration with primary care and other medical specialties, consultation with primary care teams, physical exercise groups, and crisis intervention units.(AU)

Malestar psicológico, ajuste diádico y dinámica familiar tras el diagnóstico prenatal de cardiopatía congénita / Psychological distress, dyadic adjustment and family dynamics after prenatal diagnosis of congenital heart disease

Introducción: Las cardiopatías congénitas (CC) se encuentran entre las enfermedades congénitas más frecuentes. Cuando se informa a los padres y las madres del diagnóstico de una CC durante el embarazo, tienen que afrontar una serie de cambios psicológicos a nivel individual e interpersonal. El objetivo del estudio es evaluar el impacto psicológico que produce en los padres el diagnóstico de una CC en el periodo prenatal. La muestra incluyó 214 participantes, madres y sus parejas (grupo de casos: 57 gestantes con fetos diagnosticados de CC y sus parejas; grupo control: 50 gestantes y sus parejas). Método: Administración del BSI-18, el DAS y el FACES-III tras el diagnóstico prenatal. Resultados: Muchos progenitores (alrededor del 83,6%) pasaron por fases de choque emocional y negación tras recibir el diagnóstico de una enfermedad que necesitaban afrontar y aceptar. A nivel individual, el 35,1% de los padres y el 47,4% de las madres tuvieron puntuaciones significativas en el malestar psicológico. A nivel de la pareja, tanto los padres (77%) como las madres (82,4%) presentaron un ajuste diádico idealizado. Por último, el 43,9% de los padres y el 42,2% de las madres reflejaron una dinámica familiar moderada. Conclusión: Los resultados ilustran la complejidad de la etapa inicial que atravesaban las parejas participantes. (AU)

Introduction: Congenital heart disease (CHD) is one of the most frequent congenital diseases. When expectant fathers and mothers are informed of a CHD during pregnancy, they have to confront a series of individual and interpersonal psychological changes. The aim of the study was to evaluate the psychological impact of a prenatal diagnosis of CHD on expectant parents. The sample included 214 participants, mothers and their partners (case group, 57 pregnant women carrying a foetus with CHD and their partners; and control group, 50 pregnant women and their partners). Method: Administration of BSI-18, DAS and FACES-III following prenatal diagnosis. Results: Many parents (approximately 83.6%) went through stages of shock and denial in response to the diagnosis of disease that they had to confront and accept. At the individual level, 35.1% of fathers and 47.4% mothers had clinically significant scores of psychological distress. At the couple level, both fathers (77%) and mothers (82.4%) had expressed an idealized dyadic adjustment. Lastly, the perception of the family dynamic by 43.9% of fathers and 42.2% of mothers was in the mid-range. Conclusion: The results highlight the complexity of the initial stage that these couples were going through. (AU)